26:2H-113 Instruction directive legally operative, conditions.

26:2H-113  Instruction directive legally operative, conditions.
12.  a.  If the patient has executed an instruction directive but has not designated a mental health care representative, or if neither the designated mental health care representative or any alternate designee is able or available to serve, the instruction directive shall be legally operative.  If the instruction directive provides clear and unambiguous guidance under the circumstances, it shall be honored in accordance with its specific terms by a legally appointed guardian, if any, family member, mental health care professional and psychiatric facility involved with the patient's mental health care, and any other person acting on the patient's behalf, except as provided in subsection c. of this section.

b.If the instruction directive is, in the exercise of reasonable judgment, not specific to the patient's mental health condition and the treatment alternatives, the responsible mental health care professional, in consultation with a legally appointed guardian, if any, family member, or other person acting on the patient's behalf, shall exercise reasonable judgment to effectuate the wishes of the patient, giving full weight to the terms, intent and spirit of the instruction directive.

c.Departure from the specific provisions of the instruction directive shall be permitted only if the responsible mental health care professional determines that compliance with those terms or provisions would:

(1)violate the accepted standard of mental health care or treatment under the circumstances of the patient's mental health condition;

(2)require the use of a form of care or treatment that is not available to the mental health care professional responsible for the provision of mental health services to the patient;

(3)violate a court order or provision of statutory law; or

(4)endanger the life or health of the patient or another person. 

L.2005,c.233,s.12. 

26:2H-79. Definitions relative to hospices

26:2H-79.  Definitions relative to hospices1. As used in this act, "hospice care program" means a coordinated program of home, outpatient, and inpatient care and services that is operated by a public agency or private organization, or subdivision of either of these entities, and that provides care and services to hospice patients and to hospice patients' families, through a medically directed interdisciplinary team, under interdisciplinary plans of care in order to meet the physical, psychological, social, spiritual, and other special needs that are experienced during the final stages of illness, dying, and bereavement. A hospice care program shall provide the following care and services:

a. Nursing care by or under the supervision of a registered professional nurse;

b. Physical, occupational, or speech or language therapy;

c. Medical social services by a certified or licensed social worker under the direction of a physician;

d. Services of a certified home health aide;

e. Medical supplies, including drugs and biologicals, and the use of medical appliances related to terminal diagnosis;

f. Physician's services;

g. Short-term inpatient care, including both palliative and respite care and procedures;

h. Spiritual and other counseling for hospice patients and hospice patients' families;

i. Services of volunteers under the direction of the provider of the hospice care program; and

j. Bereavement services for hospice patients' families.

L.1997,c.78,s.1.

26:2H-78. Violations, penalties

26:2H-78.    Violations, penalties       28. a.  A health care professional who intentionally fails to act in accordance with the requirements of this act is subject to discipline for professional misconduct pursuant to section 8 of P.L.1978, c.73 (C.45:1-21). 

    b.   A health care institution that intentionally fails to act in accordance with the requirements of this act shall be subject to a fine of not more than $1,000 for each offense.  For the purposes of this subsection, each violation shall constitute a separate offense.  Penalties for violations of this act shall be recovered in a summary civil proceeding, brought in the name of the State in a court of competent jurisdiction pursuant to "the penalty enforcement law" (N.J.S.2A:58-1 et seq.). 

    c.   The following acts constitute crimes:

 

    (1)  To willfully conceal, cancel, deface, obliterate or withhold personal knowledge of an advance directive or a modification or revocation thereof, without the declarant's consent, is a crime of the fourth degree. 

    (2)  To falsify or forge an advance directive or a modification or revocation thereof of another individual is a crime of the fourth degree. 

    (3)  To coerce or fraudulently induce the execution of an advance directive or a modification or revocation thereof is a crime of the fourth degree. 

    (4)  To require or prohibit the execution of an advance directive or a modification or revocation thereof as a condition of coverage under any policy of health insurance, life insurance or annuity, or governmental benefits program, or as a condition of the provision of health care is a crime of the fourth degree. 

    d.   Commission of any of the acts identified in paragraphs (1), (2), or (3) of subsection c., resulting in the involuntary earlier death of a patient, shall constitute a crime of the fourth degree. 

    e.   The sanctions provided in this section shall not be construed to repeal any sanctions applicable under other law. 

    L.1991,c.201,s.28.   

26:2H-77. Applicability of other law

26:2H-77.    Applicability of other law 
25. a.  The withholding or withdrawing of life-sustaining treatment pursuant to section 15 of this act, when performed in good faith, and in accordance with the terms of an advance directive and the provisions of this act, shall not constitute homicide, suicide, assisted suicide, or active euthanasia. 

    b.   To the extent any of the provisions of this act are inconsistent with P.L.1971, c.373 (C.46:2B-8 et seq.) concerning the designation of a health care representative, the provisions of this act shall have priority over those of P.L.1971, c.373 (C.46:2B-8 et seq.). 

    Durable powers of attorney for health care executed pursuant to P.L.1971, c.373 (C.46:2B-8 et seq.) prior to the effective date of this act shall have the same legal force and effect as if they had been executed in accordance with the provisions of this act. 

    c.   Nothing in this act shall be construed to impair the rights of emancipated minors under existing law. 

    L.1991,c.201,s.25.  

26:2H-76. Advance directive executed in other jurisdictions, validity

26:2H-76.    Advance directive executed in other jurisdictions, validity 
     24.  An advance directive executed under the laws of another state in compliance with the laws of that state or the State of New Jersey is validly executed for purposes of this act.  An advance directive executed in a foreign country in compliance with the laws of that country or the State of New Jersey, and not contrary to the public policy of this State, is validly executed for purposes of this act. 

    L.1991,c.201,s.24.   

26:2H-75. Advance directive shall not affect insurance, benefits coverage

26:2H-75.    Advance directive shall not affect insurance, benefits coverage  
     23.  The execution of an advance directive pursuant to this act shall not in any manner affect, impair or modify the terms of, or rights or obligations created under, any existing policy of health insurance, life insurance or annuity, or governmental benefits program.  No health care practitioner or other health care provider, and no health service plan, insurer, or governmental authority, shall deny coverage or exclude from the benefits of service any individual because that individual has executed or has not executed an advance directive.  The execution, or non-execution, of an advance directive shall not be made a condition of coverage under any policy of health insurance, life insurance or annuity, or governmental benefits program. 

    L.1991,c.201,s.23.   

26:2H-74. Absence of advance directive, act not applicable

26:2H-74.    Absence of advance directive, act not applicable
22.  The absence of an advance directive shall create no presumption with respect to a patient's wishes regarding the provision, withholding or withdrawing of any form of health care.  The provisions of this act do not apply to persons who have not executed an advance directive. 

    L.1991,c.201,s.22.